EMDR FORUM ARCHIVE, 2000
Re:Maxfield & Hyer meta-analysis: A few questions
Cahill · 11/02/02 at 5:57 PM ET
Louise and Sandra: Thank you for your comments on my question. There are lots of interesting ways in which the conversation could go in follow-up to your comments. I'm going to try and restrict myself to just a few because I'm still working on the Andrade, Kavanagh, stuff that I've been promising for a few days. But I really feel compelled to toss out a few words regarding the free association aspect of EMDR. I'm going to begin with Sandra's comment that free association is so important to EMDR. However, unless you can show otherwise, let's please acknowledge this is just your opinion based on clinical observation. There is no evidence one way or the other. We should also be open to the possiblities that the free association aspect of EMDR could (a) have no effect or (b) reduce the effectiveness of the treatment. Second, Louise suggest is would be interesting to compare standard expeosure where the focus is kept on the target memory to expsoure that permits free association. Well, I'm happy to tell you that, "Yes, Louise, there is a Santa Clause." The use of free association in exposure therapy is not new. Indeed, the relevant study was done by a collaborator of your colloborator: Pat Boudewyns. In the study, they compared one particular form of exposure therapy, implosive therapy, to what they termed desensitization therapy using free associations, and millieu control. Results showed that both treatments were superior to control. While there was no clear superiority of one therapy over the other, one therapy was numerically better than the other on several measures and was superior to control on more measrues. Which therapy was it? Implosive therapy. Now, let me be clear, I'm not saying that implosive therapy was superior to desensitization using free association. What I'm saying is that there absolutely no hint that it was the other way around. This is important because supporters of EMDR tend to talk as if they are working under the assumptions that the differences between EMDR and other treatments necessarily enhance outcome. My point is that, until this is demonstrated, then the assumption should be the opposite, that the putative differnce has no effect. Boudewyns, P. A., & Wilson, A. E. (1973). Implosive therapy and desensitization using free association in the treatment of inpatients. Journal of Abnormal Psychology, 79, 259-268. Boudewyns, P. A. (1975). Implosive therapy and desensitization therapy with inpatients: A five year follow-up. Journal of Abnormal Psychology, 84, 159-160.
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